A New York Times article recently relayed the stories of several women who were diagnosed with BIA-ALCL, the current statistics in the U.S. and abroad, as well as possible theories for how BIA-ALCL may develop in women who have had breast implants, particularly textured ones.

What exactly causes the disease is not known. One theory is that bacteria may cling to textured implants and form a coating called a biofilm that stirs up the immune system and causes persistent inflammation, which may eventually lead to lymphoma. The idea is medically plausible, because other types of lymphoma stem from certain chronic infections. Professional societies for plastic surgeons recommend special techniques to avoid contamination in the operating room when implants are inserted.

“It could also just be the immune system response to some component of the texturing,” Dr. Clemens said. The rough surface may be irritating or abrasive. Allergan implants seem to be associated with more cases than other types, possibly because they are more deeply textured and have more surface area for bacteria to stick to, he said.

We knew that growth of bacteria on the surface of breast implants can, over time, cause an increase in stimulation of the lymphocytes, turning them into BIA-ALCL. However, we now know textured implants, which have a higher surface area, carry a significantly higher risk of BIA-ALCL. This is because these high surface area textured implants act as a passive conduit for the growth and proliferation of bacteria.

They also reference Allergan implants, and point out that 58.7% of BIA-ALCL cases involve Allergan Biocell salt loss textured implants.

9NEWS understands clusters of cases of women who have developed ALCL after being operated on by the same surgeon have been reported.

The cancer is believed to develop from bacteria getting onto an implant before it’s inserted into a patient’s chest. Typically, it grows in a capsule of fluid around the implant and is diagnosed on average 7.5 years after surgery – although it can take decades.

Additionally, this article mentions that Professor Anand Deva, head of cosmetic, plastic and reconstructive surgery at Macquarie University in Sydney, and his research colleagues have developed a “14-point plan for surgeons to prevent ALCL.”

From a legal standpoint, this development is of particular interest, and raises some important questions. Who should be held responsible for the suffering that results from hundreds of BIA-ALCL diagnoses?

If bacterial contamination of the breast implants prior to insertion is the cause of BIA-ALCL, can the blame be placed on the manufacturers of the breast implants? The facilities in which the implant procedures are performed? The surgeons themselves? Do all parties share in the responsibility?

We will continue to monitor the medical literature concerning the association of breast implants with BIA-ALCL to look for new developments and better determine who should be held accountable for the harm that has befallen women who have received this diagnosis.

Attorney Tom Lamb

Mr. Lamb is recognized by other lawyers as practicing law at the highest level of professional experience in terms of legal ability and ethical standards — which is indicated by an AV® Preeminent™ 5.0 out of 5 rating (highest classification) rating from the Martindale-Hubbell® Lawyer Directory.

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